The New Zealand medical journal
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Smokers need new products and policies to escape smoking's risks. And the next generation needs policies that will better protect them from becoming smokers. Low-nitrosamine tobacco snuff (hereafter termed 'snuff') is 20 times less dangerous than cigarette smoking. ⋯ Tax each class of tobacco products proportionate to the respective risks of each. (Tax cigarettes at 20 times the snuff rate, instead of at the same rate.) Legislate, to expand the Smoke-free Environments Act's aims to include ending the sale of cigarettes and ending smoking deaths--i.e: Allow oral snuff to compete with cigarettes for market share (and for the smoker's nicotine receptors). Reduce addiction to smoking, by decreasing the nicotine content of cigarettes by 5% every 6 months. (Below 20% of current levels, most smokers will quit or switch to snuff.), Allot cigarette supply quotas to manufacturers and importers, decreasing by 5% every 6 months, on the grounds that cigarette smoke is irremediably toxic. The summed effects of these changes could end cigarette sales within 10 years, and prevent 90% of cigarette deaths within 22 years thereafter.
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Comparative Study
Prevalence of complementary and alternative medicine use in Christchurch, New Zealand: children attending general practice versus paediatric outpatients.
There is little information about the use of complementary and alternative medicines (CAM) in New Zealand children who attend a general practitioner for intercurrent illness compared to children attending secondary care with a chronic condition where CAM use is high. This study aims to establish whether there are differences in prevalence and non-disclosure rates, information sources, and potential predictors of CAM use in these two populations of children. ⋯ CAM-use amongst New Zealand children is higher, and disclosure rates lower, when compared to overseas populations of children. This suggests that there is greater potential for New Zealand children to be at risk of adverse events directly and through interaction with prescribed medicines. Contrary to expectations, CAM-use behaviours and disclosure rates are comparable between GP and outpatient populations--suggesting that all prescribers need to explicitly ask parents about CAM-use with their children, particularly those that report CAM-use themselves.
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Comparative Study
Passing the buck: clinical handovers at a tertiary hospital.
To survey house officers and nurses regarding timing, structure and content of clinical handover and compare these results. Secondary aims included the development of an 'on-call' sheet and the development of guidelines for handovers from the results collated. ⋯ In this study, we identified that health professionals perceive that clinical problems can be attributed to poor clinical handover. The majority of respondents in the study felt that an effective handover system should include a set location for handover, a standardised 'on-call' sheet and training related to handovers.
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Comparative Study
Punitive parenting practices of contemporary young parents.
To describe the punitive parenting practices of a cohort of young (<25 years) New Zealand parents and to examine the life course risk factors that placed these parents at increased risk of severe child physical punishment/abuse. ⋯ The use of physical punishment and more severe forms of physical assault/abuse are relatively common amongst contemporary young parents. Implications of study findings for social policy aimed at reducing levels of family violence in New Zealand are considered.
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To quantify the proportion of emergency department (ED) discharges that could have been managed in primary care, and to determine the consistency with which healthcare professionals assess cases as 'primary care appropriate'. ⋯ Our study has shown retrospectively that a significant number of ED presentations may have been managed in primary care. However this was determined with knowledge of investigation results and final diagnosis, by clinicians who had poor agreement about individual cases. In reality, triage nurses in ED have only the presenting complaint. This study shows how variable clinicians can be in determining primary care appropriateness even with full clinical details.